经腹贲门癌根治术326例分析

Analysis of 326 cases of transabdominal radical operation for cardial carcinoma

目的探讨经腹施行贲门癌根治术式的安全性及根治性。方法对1998年至2006年经腹采用管型吻合器进行纵隔内食管胃(空肠)吻合的326例进行回顾性分析。结果经腹贲门癌根治术切除范围可达癌灶以上6～8 cm食管,实现了低切缘癌残留率、低吻合口瘘发生率和低手术死亡率,其明显低于经胸贲门癌根治术。结论经腹扩大后下纵隔视野,有利于施行贲门癌根治术、纵隔内食管胃(空肠)机械吻合术,并发症低,特别适合老年体弱及伴有心、肺疾患的患者。

Objective To evaluate the safety of a surgical appwach for transabdominal cardial carci- noma.Methods We retrospectively analyzed 326 patients undergoing transabdominal esophagastrostomy or esophagojejunostomy from 1998 to 2006 via the EEA(end-to-end anastomosis)stapler.Results By the surgi- cal approach for transabdominal cardial carcinoma,the average length of reseete esophagus above the carci- noma was about 6～8 cm realized the low average of remnant carcinoma at the margin and operation mortality and anastomotic leakage,which was lower than those in the thoraeotomy appmaeh significantly.Conclusion The transabdominal approach makes a clear operative field in posterio-inferior mediastinum,it is beneficial for radical resection of eardial carcinoma and intramediastinal esophagogastric or esophagojejunal mechanical anastomosis,and it fits to the old,the weakening and with the disease of heart and lung.